TY - JOUR
T1 - Use of cannabis during pregnancy and birth outcomes in an Aboriginal birth cohort
T2 - A cross-sectional, population-based study
AU - Brown, Stephanie J.
AU - Mensah, Fiona K.
AU - Kit, Jackie Ah
AU - Stuart-Butler, Deanna
AU - Glover, Karen
AU - Leane, Cathy
AU - Weetra, Donna
AU - Gartland, Deirdre
AU - Newbury, Jonathan
AU - Yelland, Jane
N1 - Funding Information:
The authors respectfully acknowledge the Aboriginal Custodians of the Lands and Waters of Australia. The authors thank the many Aboriginal families who have played a role in development of the Aboriginal Families Study through the community consultation and development of the questionnaire; the women who have taken part; their communities and the staff in the many agencies that have supported the study. The authors would also like to thank members of the Aboriginal Advisory Group for the study and members of the fieldwork team. This study was supported by a National Health and Medical Research Council (NHMRC) project grant ID1004395, 2011-2013; the Rio Tinto Aboriginal Fund; SA Health; and the Victorian Government''s Operational Infrastructure Support Program. SB was supported by a NHMRC Career Development Fellowship (ID491205, 2008-2011) and an Australian Research Council Future Fellowship (2012-2015). FM was supported by a NHMRC Early Career Fellowship (1037449) and JY by a NHMRC Career Development Fellowship (1062484).
PY - 2016
Y1 - 2016
N2 - Objectives: Indigenous women continue to experience rates of stillbirth, preterm birth and low birth weight, two to three times higher than other women in high-income countries. The reasons for disparities are complex and multifactorial. We aimed to assess the extent to which adverse birth outcomes are associated with maternal cannabis use and exposure to stressful events and social health issues during pregnancy. Design/setting: Cross-sectional, population-based survey of women giving birth to Aboriginal babies in South Australia, July 2011-June 2013. Data include: maternal cannabis use, exposure to stressful events/social health issues, infant birth weight and gestation. Participants: 344 eligible women with a mean age of 25 years (range 15-43 years), enrolled in the study. Participants were representative in relation to maternal age, infant birth weight and gestation. Results: 1 in 5 women (20.5%) used cannabis during pregnancy, and 52% smoked cigarettes. Compared with mothers not using cannabis or cigarettes, mothers using cannabis had babies on average 565 g lighter (95% CI -762 to -367), and were more likely to have infants with a low birth weight (OR=6.5, 95% CI 3.0 to 14.3), and small for gestational age (OR=3.8, 95% CI 1.9 to 7.6). Controlling for education and other social characteristics, including stressful events/social health issues did not alter the conclusion that mothers using cannabis experience a higher risk of negative birth outcomes (adjusted OR for odds of low birth weight 3.9, 95% CI 1.4 to 11.2). Conclusions: The findings provide a compelling case for stronger efforts to address the clustering of risk for adverse outcomes in Aboriginal and Torres Strait Islander communities, and point to the need for antenatal care to address broader social determinants of adverse perinatal outcomes. Integrated responses-collaboratively developed with Aboriginal communities and organisations-that focus on constellations of risk factors, and a holistic approach to addressing social determinants of adverse birth outcomes, are required.
AB - Objectives: Indigenous women continue to experience rates of stillbirth, preterm birth and low birth weight, two to three times higher than other women in high-income countries. The reasons for disparities are complex and multifactorial. We aimed to assess the extent to which adverse birth outcomes are associated with maternal cannabis use and exposure to stressful events and social health issues during pregnancy. Design/setting: Cross-sectional, population-based survey of women giving birth to Aboriginal babies in South Australia, July 2011-June 2013. Data include: maternal cannabis use, exposure to stressful events/social health issues, infant birth weight and gestation. Participants: 344 eligible women with a mean age of 25 years (range 15-43 years), enrolled in the study. Participants were representative in relation to maternal age, infant birth weight and gestation. Results: 1 in 5 women (20.5%) used cannabis during pregnancy, and 52% smoked cigarettes. Compared with mothers not using cannabis or cigarettes, mothers using cannabis had babies on average 565 g lighter (95% CI -762 to -367), and were more likely to have infants with a low birth weight (OR=6.5, 95% CI 3.0 to 14.3), and small for gestational age (OR=3.8, 95% CI 1.9 to 7.6). Controlling for education and other social characteristics, including stressful events/social health issues did not alter the conclusion that mothers using cannabis experience a higher risk of negative birth outcomes (adjusted OR for odds of low birth weight 3.9, 95% CI 1.4 to 11.2). Conclusions: The findings provide a compelling case for stronger efforts to address the clustering of risk for adverse outcomes in Aboriginal and Torres Strait Islander communities, and point to the need for antenatal care to address broader social determinants of adverse perinatal outcomes. Integrated responses-collaboratively developed with Aboriginal communities and organisations-that focus on constellations of risk factors, and a holistic approach to addressing social determinants of adverse birth outcomes, are required.
UR - http://www.scopus.com/inward/record.url?scp=84960359014&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2015-010286
DO - 10.1136/bmjopen-2015-010286
M3 - Article
C2 - 26908527
AN - SCOPUS:84960359014
SN - 2044-6055
VL - 6
JO - BMJ open
JF - BMJ open
IS - 2
M1 - e010286
ER -